Posted
by
ScuttleMonkey
on Wednesday March 01, 2006 @06:48PM
from the fewer-restrictions-for-corrupt-corporations dept.

An anonymous reader writes "Forbes has a story listing the six most dangerous bacteria (one's actually a fungus, but it kills people who get it half the time) that have afflicted athletes, soldiers, and hospital patients. Some scientists worry that even with a bunch of new antibiotics hitting the market, there still aren't enough and they want legislation to make it easier for companies to develop them."

The title of the article is very misleading. These 6 are the bacteria/fungus that have been become the highest resistant to antibotics.

Pneumococcus pneumonia, neisseria meningitis, and strep soft tissue infections typically kill patients much quicker than the organisms listed above.... we have good antibotics for these; however, they can just overwealm the system before the antibotics have time to work.

Wrong on both counts.1. Syphilis is a spirochete, which is a bacteria. There are other bacteria in this class as well, such as the bacteria that causes 'yaws'

2. Syphilis ravaged Europe and North America among other parts of the world for centuries causing large amounts of morbidity and mortality in newborns and people in late stages of the disease. I'd say that counts as dangerous. Of course, it remains excuisitly sensitive to penicillin and we regularly screen for it now in some populations so its not

One of the larger risks during a bout of the flu is that a secondary infection will set in while a patients immune system is still weakened. The proactive prescription of antibiotics can reduce this risk.

The secondary infection is why I always take anibiotics when I get a cold. I had some health problems growing up and one time grew out pseudomonas in my sinuses. A couple week course of Cipro is almost standard for colds for me now so that the pseudomonas doesn't take over. If Cipro doesn't work, I have had some success with Levaquin. If all else fails, geocillin usually takes care of the problem. Growing up, a bad sinus infection usually meant iv treatment because I wasn't old enough to take Cipro.The

Secondary infections are not all that common after influenza. They do happen, and I tell my patients to call or come back if they aren't making the expected progress but I DONT prescribe antibiotics "just because" somebody "might" get sicker.It will take another half generation or so before the idea of getting antibiotics after every infection wanders away from people's minds. So far, I've been pleased with how many people have actually picked up on that, I'm having to dissuade fewer and fewer people from

OK, I stand corrected. But I have to question the wisdom of prescribing antibiotics for an infection that might happen. Is the creation of new antibiotic-resistant bacterial strains worth preventing a hypothetical, non-serious infection? Yes, I know, secondary infections can be a big deal if the patient has other health issues. But giving antibiotics to a person who is likely to recover without them strikes me as questionable.

My g/f is a doc (Internal Medicine) and all people want are drugs, drugs, drugs. Slightly off-topic, but no one wants to hear her tell them to quit smoking, loose weight, eat better (and less), get regular exercise, sleep more. People always want magic pills -- that are also dirt cheap and side effect free, of course.

While sometimes you are simply going to need meds, a lot of people beat the hell out of their own bodies and immune system (see above) and could help themselves a lot by living better. But t

Indeed! They want to manufacture treatments, not cures. After 10 days to 2 weeks, you don't need an antibiotic any more. Your infection is cured. They like to make pills you will have to take now, and for the rest of your life. It is all about the money.

sorry to drag another subject into this, but i have been claiming for years that the current system of drug development is wrong. in discussions about patents, I am getting sick of people always coming up with the example of the pharmaceutical industry as "proof" that patents are necessary. I would say, to the contrary.the current pharmaceutical industry system (including patents) only serves to develop new drugs that aren't really needed (broadly spoken). IMHO it is not money that should dictate what drugs

It's kind of trendy to denigrate drug companies, and trigger-happy lawyers are constantly on the prowl for any lawsuit opportunity. And the public doesn't care. Unfortunately, this will lead to a complete lack of new treatments within a few years.

Developing new antibiotics is very costly and can be dangerous. Recently, courts have punished drugs manufacturers with incredibly high damage awards. Take for instance the COX-2 inhibitors Vioxx. Granted, there were two (2) victims, but there is no proof that t

Another problem for profitability is the fact that once a new antibiotic is discovered, doctors will horde the thing and make sure to only use it when everything else fails to prolong the time until resistance becomes common.

This is honestly why government funding is needed. There's very little free market incentive to spend gobs of money on a product that people will use as little as possible.

See the problem is, you can develop 20 different types of medicine to combat different types of bacteria / germs / viruses but they will simply continue to evolve. It's life, all these things have to find some way to keep on going, just like we do.

People living in the developed world in the year 2006 are spoiled. If you take a typical human, chosen at random from among all the people on earth who have ever lived, that person didn't live in a free society, had no privacy, and died of infectious disease. Probably all three of these temporary good things that we're experiencing today will get worse soon. Freedom is going away, because the terrorists know how to make us take it away from ourselves. Privacy is going to take a big hit when quantum computer

See the problem is, you can develop 20 different types of medicine to combat different types of bacteria / germs / viruses but they will simply continue to evolve.

I would hate being killed by one of these. However, that would remove an individual with hypothetically inferior genes from the population, increasing the chances that Homo sapiens as a species would evolve to resist those germs.

As individuals, though, we don't think about the species, just about us and those we care about. Bring on the new, str

antibiotics you attempt to mimimize usage and new antibiotics would be 'last resort' so the profitability of antibiotics is very low. The market incentives just don't exist for them like they do for mass market repeat customer products like viagra.

Antibiotics are more suited for government and non profit development.

Recently, the British version of the American Medical Association (AMA) recommended that Doctors stop wearing ties and those spiffy white lab coats.

They said that since guys rarely wash their ties, they end up carrying around bugs, ditto for labcoats. The article I read specifically mentioned MRSA*, which is one of the 6 "scary" bugs TFA mentions.

I told this to my doctor and they said that the white lab coats is a:major: image thing and that patients respond much more favorably to it than normal clothes.

Recently, the British version of the American Medical Association (AMA) recommended that Doctors stop wearing ties and those spiffy white lab coats.

They said that since guys rarely wash their ties, they end up carrying around bugs, ditto for labcoats. The article I read specifically mentioned MRSA*, which is one of the 6 "scary" bugs TFA mentions.

I told this to my doctor and they said that the white lab coats is a:major: image thing and that patients respond much more favorably to it than normal cloth

Every couple of days? So the doctor should wash his hands between each patient, replace the speculum on the otoscope (insert analogous piece of equipment here) after each patient or orifice... but a piece of clothing only needs to be washed every few days?

If they won't remove and wash the lab coats & ties themselves, then hospitals and doctor's offices should install gigantic washing machines. The staff should force the doctor into the washing machine every four hours, but should refrain from using the hot wash setting. Once the wash cycle is complete, you drop them into a giant tumble drier. The problems with bacteria are now solved and, for those who survive, there's an excellent chance they will wash their own clothes more often.

If they are *White* labcoats, you could just bleach the hell out of 'em during the wash. I had assumed labcoats in hospitals were like scrubs: there's closets all over the place with stacks of clean ones for everyone.

One of the scariest things I read - a long time ago - was a piece by Bruce Sterling called "Bitter Resistance". Literary freeware - here are some legal links: at vt.edu [vt.edu]; and
at Buffalo [buffalo.edu]. Or google your own.

He spells out how bacteria acquire their antibiotic resistance: The runoff of tainted feedlot manure, containing millions of pounds of diluted antibiotics, enters rivers and watersheds where the world's free bacteria dwell.
In cities, municipal sewage systems are giant petri-dishes of diluted antibiotics and human-dwelling bacteria.
Bacteria are restless. They will try again, every twenty minutes. And they never sleep.

If you haven't read it already, click the link - it is well worth it. It still scares the hell out of me, and it looks like his dark vision is coming true...

The runoff of tainted feedlot manure, containing millions of pounds of diluted antibiotics, enters rivers and watersheds where the world's free bacteria dwell.

One way we could slow this down is to ban the use of anti-biotics in feed for livestock. This practice is insane, it's almost as bad as if farmers and ranchers were deliberately trying to breed anti-biotic resistant bacteria to kill people.

One way we could slow this down is to ban the use of anti-biotics in feed for livestock.

I would prefer we got rid of all those stupid anti-bacterial dish soaps and hand soaps. Antibacterial soap is redundant, it's already SOAP for chrissake, and it contributes to exactly the situation described by the grandparent post.

I would prefer we got rid of all those stupid anti-bacterial dish soaps and hand soaps. Antibacterial soap is redundant, it's already SOAP for chrissake, and it contributes to exactly the situation described by the grandparent post.

I'd agree that anti-bacterial soap is just stupid and serves no purpose other than marketing to obsessive-compulsive people. But they really aren't the same thing as an antibiotic. Anything, including bleach or acid can be anti-bacterial. I don't know that anyone has shown tha

Well, it's all up to the honesty of the farmer, actually. Most veterinary drugs have withdrawl times to make sure that they're out of the system of the animal. Ivomectrin is like 60 days or something like that (it's probably the most popular, and powerful, broad spectrum anti-parasitic drug. And it just went generic in the last year or so...).If you're getting locker meat, the butcher/slaughterhouse is not testing the meat (locker meat, where you ostensibly buy the animal from the farmer and pick it up in n

Dairy farms aren't what the original poster was referring to. The problem is that many farmers add antibiotics to the feed of say chickens because it increases either the growth rate, or the eventual size (I forget which) of the chickens. By doing this you create a wonderfull environment for antiobiotic resistant strains of these bugs to appear in the food supply.

The rules for dairy cattle and beef cattle are very different. Most people aren't aware of the ban on antibiotics for dairy cattle or that it goes so far that companies that sell milk can't advertise the lack of antibiotics as a feature since everyone else has to do it too.Beef cattle are very different. Farmers use antibiotics in them because it causes them to grow larger. This is widely considered to be a potential problem for helping to spread immunity to bacteria that can infect humans, but there are

You are absolutely right. And if a random quick check reveals evidence for a BSE case in the US, then the material has to be validated again by a specialized (say qualified) lab in the UK where they use reliable tests.But, you cannot donate blood in the US if you lived in Europe.http://www.redcross.org/services/biomed/blood/supp ly/tse/bsepolicy.html [redcross.org] Of course, Europeans donate blood for Europeans, without a problem. The problem is that people in the US confuse the UK with the EU. Anybody who thinks that the

1) Not all that long ago (1970s?) some people thought that we might be at a point where antibiotics would eradicate infections thus new antibiotic research slowed down accordingly. That slowed down new antibiotics coming to the market for a while, thankfully that is abating if not totally gone.2) We're encountering new and deadly diseases as we increase trade globally, it is inevitable that some will be very dangerous and exotic.

3) Each new bug has to be researched and targeted, remember that the average d

I'm a mycologist and study fungi that infect plants (not animals). I, however, am extremely familiar with Aspergillus. People don't realize that fungi such as this Aspergillus, and the less harmful and closely related Penecillium, are extremely common in our environment. You breath in spores of these things by the thousands each day! They are also the scurge of introductory plant pathology and microbiology courses everywhere because they contaminate everything.Fungal infections in people are nasty. They can

Out of spite for Forbes, here's the list (yeah yeah, you can click slower/faster/stop)...

Methicillin-resistant Staphylococcus aureus (MRSA)
Drug-resistant "staph" causes 102,000 hospital infections a year, more than any other. For sick patients, it can be a killer. Recently, S. aureus has escaped the hospital. The number of children infected jumped 28% in three years. Now, athletes are being infected. In 2003, five football players on the St. Louis Rams suffered staph-infected turf burns that resisted multiple antibiotics.

Escheria coli and Klebsiella
These bacteria, a major cause of urinary tract, gastrointestinal and wound infections, are quickly becoming resistant to existing drugs. Half of Klebsiella, for instance, were found to be resistant to Cipro in a recent study. More worrisome, two experimental drugs being tested against these bacteria are in the same class as drugs to which the bugs are already resistant.

Acinetobacter baumannii
This drug is perhaps most well known for its presence in troops returning from Iraq, where it has infected dozens of patients and spread to others inside hospitals. It is also an increasingly common cause of pneumonia, now accounting for 7% of hospital-acquired cases. There are few existing drugs to treat it, and no medicines in development targeted at this bug.

Aspergillis
Cancer patients, transplant patients and others with weak immune systems are at risk of being infected with this fungus. Once it gets loose in the bloodstream, aspergillis kills 50% of the time or more--and that's with the best new antifungal drugs that have been developed in recent years. Experts complain that drug companies are choosing to test their medicines on other, easier-to-treat fungal infections.

Vancomycin-resistant Enterococcus faecium (VRE)
VRE is a major cause of infection of the heart, brain and the abdomen. A recent survey of 494 U.S. hospitals found infections of 10% across all patient groups. Current drugs do not rapidly kill the bug, and only one is available as a pill.

Pseudomonas aeruginosa
This bug is better than most other bacteria at becoming resistant to new antibiotics. A third of P. aeruginosa were found to be resistant to drugs like Cipro and Levaquin in 2002. Patients with cystic fibrosis are at particular risk; antibiotics can keep them healthy, but once bacteria become resistant, they may need lung transplants.

Bacterial resistance? It's an exercise in futility: doctors are very careful in prescripting antibiotics unnecessarily, but as far as I know, animal feed is laced with antibiotics (makes them grow faster, and you get less disease in crowded conditions). The antibiotics used are related to the ones used in humans. All this resistance came not from antibiotics we use on ourselves, since it is dwarfed by those use for feeding pigs and chickens... Who to blame though? This is a classic case of the "tragedy of the commons" - if one doesn't use antibiotics for his/her farm, one's competitor will.

Aspergillis
Cancer patients, transplant patients and others with weak immune systems are at risk of being infected with this fungus...

As a leukemia patient, these kinds scare the shit out of me. Every once in a while my white blood cell count gets low as the Doc adjusts my dosages, and every time I just hold my breath and hope. Maybe I am overly sensitive, but reading things like this make me doubt that....

Hmm... Poultry feed typically (it's hard to buy unmedicated poultry feed, btw, because chickens and turkeys get cocci, and get screwed up by it, rather easily) has amprolium in it, to prevent coccidiosis. Ruminant feeds can have some amprolium or antibiotics to prevent "overeating disease" (onset by ruminants typically moving off of grass feed to grain, like when they get moved to a feedlot). I have a bottle of sulfamethiazine sodium (sulmet) sitting on my table here, which can be used in water supplies to

I acquired it while I was in the hospital in 2004 to have some more of my leg cut off (although the doctors said I might have colonised me outside of the hospital and gone active once they did the surgery, yeah right). The treatment for MRSA was eight weeks of IV Vancomycin and 1000mg of Cipro every day. Now Vancomycin is nasty, nasty stuff, it's pH is so low that it will kill any veins you have it injected into, so you have to deliver it through a central line. It can also cause liver and hearing damage, so if you're on it for any length of time you have to get your liver enzymes tested and your hearing check. It's the next best thing to being on chemo. Cipro is no fun either and it's really fucking scary that there are bacteria that are resistant to these because these drugs, due to their side effects, are the anti-biotics of last resort, anything stronger would probably kill you outright instead of just damaging your liver and hearing.

I've been on cipro (oral and otic both) more than once, and never noticed any side effects (well, nausea once, but that was mild, and I don't know if it was the cipro or the secondary infection I had) that aren't also associated with 'weaker' drugs like amoxicillin, levaquin, etc. Can you elaborate? Cipro is also not a drug of last resort - it's actually a lot more common than most people think. Vancomycin is, though.

This is the type of article that I hate. It is pure scare tactics in a not even veiled attempt to push a political agenda for big pharmacheutical companies - be afriad! Resistent bacteria are on the rise! We need leglistation that makes it easier for big pharm to make money!Heres the catch 22 - there are bugs resistent to the drugs we currently have because of overuse of those drugs, so what we need is more new drugs to combat these? obviously they just become resistent to these drugs as well! Therefore the

You are absolutely correct. Overuse of antibiotics has contributed to the rise of antibiotic resistant bacteria. Usage patterns need to change. However, if we were to correct these problems overnight, we would still be confronted with the drug resistant antibiotics that are already here. Therefore, government funding for new antibiotics is absolutely necessary. I can also understand that the prospect of subsidizing big Pharma is also painful, especially when we know that they will turn around and overprice

In the absence of constant selective pressure to maintain antibiotic resistance, the resistance is lost in the population. There's some research on this topic that I read and which you can probably find by careful searching of PubMed.Eliminating antibiotics in animal feed, preventing people from flushing meds down the drain, more targeted treatment and effective babysitting of the worst 5% or so of the chronic homeless (which cause most of the health care costs, see Gladwell's article in The New Yorker [newyorker.com]), an

If the federal research contracts are there for development of antibiotics for particular bacteria, and if big pharma doesn't like the terms, you can be certain that new companies will quickly form that will be happy to have the work.

More antibiotics is what is getting us into this mess in the first place. Seriously, people get a simple cold and run to their doctor to get a prescription; Mothers run around their house disinfecting everything with wipes and sprays. Parents medicate their children every chance they get. How long until our immune systems aren't worth sh*t anymore because we never get exposed to the little bugs in the first place until it's too late, and how long until we have a pandemic of a human-transmittable infection that has grown immune to all known antibiotics because everybody is pumped full of them all the time?

I'll summarize the article for you: Picking your nose and eating boogers is great for your immune system.

Of course... at a certain age, in most countries (not China apprently) you're taught that eating your boogers is 'bad'. Personally, I find the idea disgusting, as I've been socialized to think so, but do you think we should

The most important part of having strong immune systems is to allow illnesses to run their course, keeping controls on activity so that it doesn't get out of hand. However, the economy will suffer as you'd have a massive fall in the workforce that could work at any given time, and it would also force businesses to massively increase the number of available sick days.

(Some businesses will sack you if you fall ill. That won't work, in a society that promotes strong immune systems. Indeed, businesses would hav

Here's a thought. If things get really nasty and these bugs get out of hand, perhaps we will see a "war on bacteria". Imagine what our best and brightest could do with a few hundred billion dollars for antibiotic research?

Eh... given how successful the "war on drugs", the "war on poverty", the "war on AIDS", and all those other wars on social/medical problems are turning out, let's not and say we did.

I don't mind funding research, but there are only so many people out there smart and educated enough to make good use of the money. Putting extra in doesn't get you better results, it just creates large self-sustaining bureaucracies.

We've already had one. After a huge global effort, the World Health Organization announced the eradication of smallpox [cdc.gov]in 1980. It was supposed to be the first victory in the war against infectious disease. Of course, it turned out to be the only victory, and even it was undermined by the fact that the US and Russia (and heaven knows who else!) kept stocks "just in case".

The interesting thing is that this one and only victory was won by immunization, not by drugs. Maybe the development of hordes of new ant

It might also help if every product out there wasn't antibacterial in some way; it's just not generally necessary for every cleaning product you use to have antibiotics in them. It's actually hard to find handsoap nowadays that _isn't_ antibacterial.

They don't have antibiotics, in the sense that we're discussing them here. They're just harsh to bacteria. As an aside: Ordinary hand soap will kill HIV. Problem is, injecting it will kill you, too...:)

. . . and by "legislation". . . I assume they mean "more government handouts, tax breaks, bogus tort-reform to free them from responsibility for adequate testing, and patent extensions"

I don't think it's unreasonable for companies to expect a profit from their research. New antibiotics are usually reserved for patients that have exhausted the more common ones, so the company won't sell many units. But the cost to prove safety and efficacy is the same as a new hypertension drug that millions of people co

But the main point isn't what Forbes says, to develop more drugs to treat Drug Resistance.

A better point would be to take A Giant Rubber Mallet and Hit Up Side The Head anyone using anti-bacterial soaps, kleenex, sprays, cleaners, etc.

JustUseSoap

Seriously, this fad to use anti-bacterial soaps and cleansers:

a. does not work - many studies show that soap, by itself, works as well or better, and not even fancy soap at that, just basic soap

b. builds resistance to antibiotics

c. creates havoc in our streams and rivers as we flush them down our toilets, sinks, and shower/bathtubs

Now, if you want to talk Drug Resistance, I heard a fascinating seminar yesterday at the UW from Christopher Lee, on Mapping Evolutionary Pathways of HIV-1 Drug Resistance, presented by the Center for Computational Biology. He's got a website [ucla.edu] that has links to at least one of his papers. There he uses evolutionary pathways predictions of Ka/Ks to manipulate viral evolution in ways that you can either slow the drug resistance evolution or force it to evolve into a the equivalent of low-energy traps they have a hard time evolving out of.

Yep. It's the mechanical action of washing one's hands, along with the chemical action of the soap on most germs, that does the most good. If the soap doesn't bust open the germs, it helps carry them away in suspension.

I think that when antibiotics are given, multiple types must ALWAYS be given.I am not sure if this is the situation today, but assuming multiple anti-biotics require multiple mutations for the bacteria to survive, then multiple antibiotic types should be used to make the antibiotics last longer.

If an antibiotics A requires a mutation with chance P(A) and an antibiotics B requires a mutation with chance P(B), then the combination requires a mutation with chance P(A)*P(B). Giving the antibiotic types separately results in a: MIN(P(A), P(B)) chance of the mutations occuring.

In other words, if we give people "the next" antibiotic type every time, we are "burning" the antibiotics much faster than if we give as many antibiotic types at the same time.

All this assuming different mutations are required to survive multiple antibiotic types.

Since I thought about this in a few minutes of my spare time, I assume that doctors/biology experts know this. My question is: Is this applied? Or is there something I am missing?

We have the expertise! We just need the equipment and salaries. I am, of course, an academic researcher in biology. I don't personally have interest in anti-microbial research, but there are plenty of us Ph.Ds who do. The problem is, the only choices we have are to stay in academia, where product devlopment is nil, or go to industry, where the bottom line takes precedence over all else. I propose more funding to academic labs (and even national labs) specifically to develop antibiotics (and eventually

That small step forward, presumably, includes the three years of medicinal chemistry to optimize the compound and find a suitable formulation, the seven years of clinical trails, and compiling the 250,000 page submission file for the FDA?

These days, the cost of developing a drug and getting approval for it is equivalent to the defense budget of a modest country -- say Vietnam or Syria. These procedures are well above the normal levels of academic funding. I doubt that many academics would be really intere

The current theories on the cause of antibiotic resistant bacteria place the blame on antibiotics and their overuse or under use. These theories utterly fail to explain one simple fact: most people don't come into the hospital with cases of drug resistant bacteria, they acquire those infections while in the hospitals. Some where in the hospital there are conditions which are breeding drug resistant bacteria.I believe that the real cause of antibiotic resistant bacteria is far more prosaic than anyone has su

Some scientists worry that even with a bunch of new antibiotics hitting the market, there still aren't enough and they want legislation to make it easier for companies to develop them.

Is it really the scientists asking for this? Surely scientists understand the relationship between antibiotic use and the development of antibiotic-resistant bacteria? I would say it would be the scientists' employers who are PUSHING as hard as they can to relax all laws that stand in their way of creating & marketin

While these bugs are pretty bad, particularly when you find them growing in a patient who is critically ill and already has other organ systems compromised (e.g., the typical ICU patient), they typically don't kill you right away. Like mentioned by Davak, Streptococcus pneumoniae (which, as the name implies, is the most common cause of bacterial pneumonia, but is also the most common cause of bacterial meningitis), Streptococcus pyogenes, and plain, run-of-the-mill, methicillin-sensitiveStaphylococcus aureus (the latter two can cause necrotizing fasciitis—they are the so-called flesh-eating bacteria) will all probably kill you much faster. Patients with these three can present perfectly well then become overwhelmingly septic then dead in less than 24 hours.

The ones mentioned in the article, however, are really all over the place and quite prevalent in the environment (yes, even MRSA—at least where I practice medicine, the prevalence rate of community-acquired MRSA is somewhere between 30-50% of all Staph infections. They are no longer exclusive to the hospital.) They generally don't cause problems in people who have intact immune systems and have intact normal flora. The reason you run into trouble is that patients who have these bugs growing in their bloodstream or eating their lungs are usually already very sick, which automatically means their immune systems are shot out. And if they've been sitting in the hospital for a while, chances are they've had their share of powerful antibiotics which have wiped out all their friendly, benign bacteria that often keep these bad actors in check.

The Gram-positive cocci that get resistant—Staph. aureus and the Enterococci—are still pretty much killable. If you get MRSA, the community-acquired variants still tend to be sensitive to other drug classes like clindamycin, the sulfas, and the tetracyclines. The hospital-acquired variant tends to be tougher, but there's always vancomycin. There have been a few reported cases of vancomycin-resistantStaph. aureus but there haven't been massive outbreaks—yet. Vancomycin-intermediate forms are more common, however. Then there's VRE (vancomycin-resistant Enterococcus). For these, you can use linezolid, and so far this works pretty well, although there have been isolated cases of resistance as well (though much less common than vancomycin resistance.) What freaks me out, though, is that we're starting to use this stuff like candy, especially since it's available as a pill.

The nastiest bugs, though, are the Gram negative rods, which include E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumanii. We tend to treat Pseudomonas with a lot of respect because it becomes rapidly resistant to antibiotics, and if we find it, or even just suspect it, we start off with two agents at least off the bat. Acinetobacter, on the other hand, is pervasive in the environment, and usually only starts causing problems when it has overgrown, usually in chronically-ill patients who have been in and out of the hospital a lot and who have gotten frequent antibiotics or, as mentioned, in ICU patients who have gotten multiple courses of antibiotics. The problem is that it is very hard to kill, since it is frequently multi-drug resistant and we often have to start out with big guns like meropenem. The abuse of penicillins and cephalosporins has caused an ncreasing prevalence of bacteria with extended-spectrum beta-lactamase activity, and even these big guns don't always do the trick against these puppies.

What scares me the most is the fact that there are really no new drug classes in the pipeline targetting Gram negative rods. The newest classes—fluoroquinolones, carbapenems, and monobactams—really haven't seen much development since the 1980s, and fluoroquinolones at least have already become

Regular soap doesn't kill bacteria, it just washes it down the drain. In the article I read, this washing away was as effective as antibacterial soap in removing the bacteria on hands, so long as you don't care what's in the wastewater.

what is it that the anti-bacterial agents have that the soap does not?

triclosan or something similar. chemicals that inhibit bacteria by destroying the cell wall with brute force like soap or alcohol are not really going to breed resistance. however, improper washing may help breed stronger versions of them (if you only wash a lil and the stronger ones survive).

but complex-acting chemicals like triclosan and antibiotics can be resisted by regular old evolution.

It has since been shown that the laboratory method used by Dr. Levy was not effective in predicting bacterial resistance for biocides like triclosan, based on work by Dr. Peter Gilbert in the UK [1] (PMID 12957932). At least seven peer-reviewed and published studies have been conducted demonstrating that triclosan is not significantly associated with bacterial resistance, including one study coauthored by Dr. Levy, published in August of 2004 in Antimicrobial Agents and Chemotherapy (PMID 152

Some scientists worry that even with a bunch of new antibiotics hitting the market, there still aren't enough and they want legislation to make it easier for companies to develop them."...

Insert missing part of summary here:"Will this evil genius, yet incompetent Bush administration have the guts to pass this legislation? Or will we all be dead in a decade because monkey boy doesn't believe these bacteria can evolve? Go Ralph Nader!"

Note to mods: I didn't write that. It actually was in the summary. Must

If you read the article, they actually do mention one antibiotic that dropped out of use due to the liver damage it caused that has been brought back out recently to fight some of these infections.

However, as someone who's been there (not with antibiotics), using medicines that can cause worse problems than the original disease (but at least kill you more slowly) sucks overall. I am all in favor of any attempts to permanently replace these with something safer.

Doctors have almost forgotten about some of these because they should only be used as a very last resort.

That, and the fact that they're out of Patent, so they're not as big a profit for the drug companies --- and the flyers about the new drugs are going to tell you all about the problems of the unpatented versions and... unh, de-emphasize the problems with the newer, higher priced, drugs.